Breast cancer and men

Melissa Erickson More Content Now

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Oct 12, 2018 at 2:55 PMOct 19, 2018 at 11:25 AM

This article appears in Paint it all Pink magazine 2018.

Having a mother or daughter who carries a mutation on the BRCA1 or 2 genes puts women at an increased risk of developing breast and ovarian cancer. The same is true for men, although few men undergo genetic testing.

“Men are equally as likely as women to inherit a BRCA mutation,” said Dr. Christopher Childers, a resident physician in the department of surgery at the David Geffen School of Medicine, University of California-Los Angeles. “If a male has a BRCA mutation, his risk of breast cancer increases a hundredfold.”

A study published in JAMA Oncology in April found that few men are screened for BRCA genetic mutations. Analyzing data from the 2015 National Health Interview Survey, researchers found that men underwent testing for breast/ovarian cancer genes at one-tenth the rate of women.

It may be the first national study analyzing the rates of genetic cancer testing for both men and women, Childers said.

“Men who carry BRCA mutations are at higher risk for a variety of cancers including breast, prostate, pancreatic and melanoma. In particular, males who carry BRCA2 mutations are at increased risk of often early and more aggressive prostate cancers,” Childers said.

Check family historyPrevious studies have shown that men believe breast cancer is a female issue, but this couldn’t be further from the truth, said genetic counselor Kimberly Childers, study co-author and regional manager at the Center for Clinical Genetics and Genomics at Providence Health & Services Southern California. The Childerses are married.

“The strongest risk factor for carrying a BRCA mutation is having a family member with a BRCA mutation. If your mother, father, sister, brother or child has a BRCA mutation, you have a 50 percent chance of having the mutation as well,” Kimberly Childers said.

Other factors that may indicate a high probability of carrying a mutation include a personal history of male breast cancer, pancreatic cancer or high-grade or metastatic prostate cancer, Kimberly Childers said.

“Men without a history of cancer may also be at risk of carrying a mutation if there is a strong history of these cancers in their family,” she said. “It’s important for men to know that if their female relatives have ovarian or early breast cancers, that this may translate into a higher cancer risk for them, too.”

Course of actionMen with a BRCA mutation are recommended to undergo clinical breast exams every year starting at age 35, Christopher Childers said.

“Once a BRCA mutation is identified, it is important that they ask their doctor to show them how to perform a self-exam of their chest, learning what abnormal tissue might feel like and what could be of concern,” he said.

Most but not all breast cancers in BRCA-positive men occur after age 50. Starting at 45, men with BRCA mutations are often recommended to undergo prostate cancer screening (prostate-specific antigen and digital rectal exams), Christopher Childers said.

If men are concerned about their risk they should discuss it with a primary-care provider or genetic counselor. To find a local genetic counselor, visit nsgc.org/findageneticcounselor.